Frontiers in global women's health · 2026
Effectiveness of a cluster management strategy on maternal and neonatal outcomes in high-risk pregnancies with hypertensive disorders: a retrospective cohort study.
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Zhang Longhua, Wang Yilin, Jiang Lingling, Gu Ying, Deng Xiaokang
Аннотация
BACKGROUND: Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and perinatal morbidity. Traditional management often lacks systematic integration of preventive and therapeutic measures. This study evaluated the efficacy of a cluster management strategy in high-risk HDP pregnancies.
METHODS: A retrospective cohort study was conducted on 103 pregnant women with HDP risk factors admitted between January 2024 and February 2025. Patients were categorized into an Observation Group (cluster management, n = 55) and a Control Group (routine care, n = 48). The cluster management strategy integrated early aspirin prophylaxis, dynamic blood pressure thresholds, and precise volume management.
FINDINGS: Despite having significantly higher pre-pregnancy BMI (26.64 ± 4.33 vs. 24.14 ± 4.92 kg/m2, P < 0.05), the Observation Group exhibited a delayed onset of proteinuria compared to the Control Group (34.67 ± 5.06 vs. 31.50 ± 7.69 weeks, P = 0.021). The incidence of pleural/peritoneal effusion (25.5% vs. 52.1%) and hypoproteinemia (18.2% vs. 37.5%) was significantly reduced in the Observation Group (P < 0.05). Crucially, the mean gestational age at delivery was prolonged to 37.51 ± 1.94 weeks in the Observation Group, compared to 34.57 ± 2.90 weeks in the Control Group (P < 0.001). Consequently, neonatal outcomes improved, evidenced by lower NICU admission rates (52.7% vs. 85.1%) and reduced hospitalization costs (P < 0.001).
CONCLUSIONS: A cluster management strategy based on early pharmacological prevention and comprehensive monitoring effectively delays disease progression and prolongs expectant management duration in high-risk pregnancies, offering significant clinical and health-economic benefits.
METHODS: A retrospective cohort study was conducted on 103 pregnant women with HDP risk factors admitted between January 2024 and February 2025. Patients were categorized into an Observation Group (cluster management, n = 55) and a Control Group (routine care, n = 48). The cluster management strategy integrated early aspirin prophylaxis, dynamic blood pressure thresholds, and precise volume management.
FINDINGS: Despite having significantly higher pre-pregnancy BMI (26.64 ± 4.33 vs. 24.14 ± 4.92 kg/m2, P < 0.05), the Observation Group exhibited a delayed onset of proteinuria compared to the Control Group (34.67 ± 5.06 vs. 31.50 ± 7.69 weeks, P = 0.021). The incidence of pleural/peritoneal effusion (25.5% vs. 52.1%) and hypoproteinemia (18.2% vs. 37.5%) was significantly reduced in the Observation Group (P < 0.05). Crucially, the mean gestational age at delivery was prolonged to 37.51 ± 1.94 weeks in the Observation Group, compared to 34.57 ± 2.90 weeks in the Control Group (P < 0.001). Consequently, neonatal outcomes improved, evidenced by lower NICU admission rates (52.7% vs. 85.1%) and reduced hospitalization costs (P < 0.001).
CONCLUSIONS: A cluster management strategy based on early pharmacological prevention and comprehensive monitoring effectively delays disease progression and prolongs expectant management duration in high-risk pregnancies, offering significant clinical and health-economic benefits.